Continuous Glucose Monitoring in Hospitalized Patients With Type 2 Diabetes: A Step Forward in Inpatient Glycemic Control.

Objective: To determine the effect and safety of continuous glucose monitoring (CGM) use in glycemic control compared to standard approach in hospitalized patients with type 2 diabetes.

Methods: This was a pilot randomized controlled clinical trial that enrolled 37 hospitalized patients with type 2 diabetes admitted in medical and surgical wards. All patients used CGM (Abbott FreeStyle2 or FreeStyle3) and concomitantly 6-point point of care glucose. In group A (n = 19), daily CGM profiles, alarms, and trend arrows were considered for glycemic therapeutic decisions and in group B (n = 18) were based on point of care glucose. Primary outcomes included the difference in time in range 70-180 mg/dL, hospital glycemia risk index, time below range measured as the percentage below 70 mg/dL and below 54 mg/dL, and time above range measured as the percentage above 180 mg/dL and above 250 mg/dL.

Results: Time in range was higher in group A: 78.26 ± 10.83% vs 67.39 ± 19.13% P = .04. Time above range level 1 in group A: 14.37 ± 8.33% vs group B: 23.28 ± 16.62% P = .04. Asymptomatic hypoglycemic events were more detected by CGM-group (1.65 ± 2.03 vs 0.31 ± 0.60 P = .01). Overall mean absolute relative difference: 14.7%. Diabetes technology society error grid: 69.5% zone A and 29.3% zone B.

Conclusions: The implementation of CGM in hospitals could represent a significant advancement in diabetes management, offering a more comprehensive and dynamic approach to monitoring glucose levels. Further research is needed to explore the long-term impacts of CGM on clinical outcomes and to optimize its integration into hospital protocols.